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First Person

Kettlebells for the Brain

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doi: 10.1097/01.EEM.0000511954.63466.c6
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    Scott Weingart, MD, gave this lecture at the Social Media and Critical Care conference in Dublin in June, and dedicated it to John Hinds, MD. Listen to the full podcast of this lecture athttp://bit.ly/BrainKettlebells, where you can also find slides and a video and resources about meditation.

    Meditation has the worst PR campaign in history. It started getting ruined by the hippies in the '70s, and now it's been taken over by tech entrepreneur jerks and folks pandering it on TV, but there's nothing spiritual in that. Meditation is science. It is cognition. It has proven benefits from something that most of us aren't doing that we probably should be.

    I wanted to eliminate any spirituality from this: It's kettlebells for the brain. We all exercise our bodies, but we could do the same for our brains. It probably has far more benefit than how good we look in a pair of jeans.

    There are two types of meditation. The first is focused attention meditation, otherwise known as vipassana. We spend most of our time in what neuropsychologists call default mode network. It's a world of daydream, when you're not actually focused on a task. Your brain is going through these revolutions without you having any conscious awareness, and thoughts are popping into your head. You're talking to yourself almost as if you're a schizophrenic. But you don't say it out loud, so no one thinks you're crazy.

    When you actually ponder the fact that you're not aware of what's going on in your head 90 percent of the time, that's a little bit worrisome. Just spending a few minutes each day actually aware of what's going on in your brain could have enormous benefits. The putative benefits of meditation, and there's science behind all of this, include such things as stress control, relaxation response control, slowing of telomere degradation, better insight into emotions and body sensations, increased concentration, and all the benefits of flow state.

    It purports to lead to a deeper appreciation of the good things in your life. But forget about all of those. I'm going to tell you about one objective benefit for meditation I've felt myself, and I guarantee you that if you do the work for a few weeks, you'll start to notice as well.

    Deeper Appreciation

    It's best embodied by this quote by Viktor Frankl, a neurologist, psychiatrist, and Holocaust survivor who founded existential analysis: “Between stimulus and response is a space. In that space is our power to choose our response. In our response lies our growth and freedom.”

    Think about that. How much of our life is spent in cause and effect? Someone does something infuriating, and we get angry. Someone does something annoying, and we get frustrated, and we just view that stimulus-response connection as natural and unavoidable. Then we recite all the reasons we were perfectly justified in getting angry. But there is a way to break the immediate connection between stimulus and response; there is a way to take that potential space and make it an actual space. If you do that, then you actually have the choice. If you have that moment of space, you can decide how to respond.

    A 2-year-old will be angry and scream if she doesn't get dessert, and that's natural, and yet we're still doing the same thing. We're still letting others choose the responses we exhibit. What meditation offers is the ability for you to choose the response you want to have. It's not going to make you a blissed-out stoner; it will merely allow you to decide how you want to go about your day.

    Now there's a downside to this because all of a sudden you can't blame other people for how you react; you have to take it all in yourself. But there's also the ability to respond to good stimuli in our lives. All of a sudden, when good things are happening, we have the ability to appreciate it at a much deeper level.

    If you're going to make this happen, you've got to buy a few things. You definitely want to get a specific set of robes for this, preferably saffron. It helps to have a specially designed cushion, and the incense is optional, but I highly recommend it. And then definitely some Tibetan prayer bells. Of course, that's all nonsense. Here's what you need: a hard-backed thing to sit on, and you don't even need that. You can do it lying down, but most of you will fall asleep when you first start. Just find something you can sit in that's going to keep you upright.

    Mindfulness Meditation

    This is based on a book by Michael Taft called The Mindful Geek: Secular Meditation for Smart Skeptics, and I highly recommend it as a great source for learning how to do this in a totally scientifically based way. He says, “Mindfulness is paying attention, nonjudgmentally, to the unfolding of experience, moment by moment.”

    Let's break that down: “Mindfulness is paying attention.” You have to pay attention to your present circumstance, and the way I'm going to teach you to do that is by linking it to your breath, a thing that happens all the time without any volitional control, and yet you can take conscious awareness of it.

    “Nonjudgmentally.” Nonjudgmentally may be the most important part of this, because as you're trying to do this, as you're trying to concentrate on your breath, you're going to realize that thoughts are popping into your head. If you're a type-A, goal-directed person, you might get upset. You might get angry at yourself, “Why can't I just concentrate?” Don't do that. Just say, “OK, I lost the train for a second. I'm just going to go back to my breath.” Do it nonjudgmentally without getting upset at yourself.

    “To the unfolding of experience, moment by moment.” Here's how you actually do that. Close your eyes, sit up nice and straight, and just start taking deep breaths in and out through your nose. As you do that, bring your attention to the feeling of that breath going through your nostrils. Thoughts are going to go through your head. Feelings are going to go through your head. Perhaps discomfort is going to go through your head. Each time you feel one of those things, you think one of those things, just come back to your breath. Don't get angry. Just keep doing that for the next eight minutes.

    It's sounds easy to describe — it's actually much harder in practice — but you'll get better and better, and that will give you the benefits of meditation. If you can do this 10 minutes a day, four days a week, you will reap enormous benefits in your life. And if you're willing to do it for a month, I promise you, you will see objective changes in the way you process and in the way you interact with people. That's vipassana, mindfulness meditation.

    Negative Visualization

    Another meditation type, contemplative meditation, is a little bit different. This is from is a group called the Stoics. The Stoics are misunderstood. William Irvine in his book, A Guide to the Good Life: The Ancient Art of Stoic Joy, explains: “Unless you're an unusual individual, everything you know about Stoicism is wrong. The common belief is that the Stoics were anti-emotion, and that simply isn't true. What they were against is negative emotions, emotions like anxiety, fear, envy, regret, and hatred. They wanted to eliminate those emotions to the extent possible.”

    Stoicism is a philosophy of happiness, how to achieve a good life. We've lost out on a lot of these philosophies that the Greeks and Romans had. Instead of meanderings of thought, which is what I find philosophy to be now, it was actually really useful information on how to live a better life. One of the main ways the Stoics advocated to live a better life was encompassed by a practice that I've adopted. My son is 5, and every day for a few seconds, I visualize him dead in my arms. That sounds horrible, but it's a practice called negative visualization. If you start doing it, it will change your life for the better.

    Mr. Irvine explains: “The Stoics, as part of their philosophy of life, devise strategies for dealing with their losses. One very important strategy, in fact, I'd be happy to call it the central strategy of the Stoics, involves what I call negative visualization. The Stoics thought we should periodically take time to contemplate the bad things that can happen to us. They thought by doing this, we could live a happier and more meaningful life. And I know that sounds like strange advice to make ourselves happy by entertaining gloomy thoughts, but let me explain what they had in mind.

    “A stoic will engage in negative visualization. In these visualizations, he will imagine that he's lost the things in his life that he values. This might include his spouse, his children, his car, his job, his health. By visualizing in this manner, the Stoics reasoned, we could overcome the tendency that humans have to take whatever it is they've got for granted.”

    Think about this: Have you ever been at the end of a relationship, realizing it's about to be over, and suddenly all the good things that relationship encompassed go rushing through your brain? All the annoyances and frustrations disappear, and you wish you could change the way things played out. When you lost someone, you think of all the amazing things, and they just run through your mind. It was a primacy that was gone, that wasn't there before you lost them, before someone left.

    What if you could have that same mental reset every day while the people you love are still there? That's what negative visualization is about. For a few seconds, visualize your son gone, and then what floods through you is an immense appreciation that he's still there. Imagine your wife leaving you, so you can realize how important she is to you. That's the benefit of negative visualization.

    I dedicated this lecture to John Hinds. John was one of the first friends I lost, the first contemporary. I had lost grandparents, great-grandparents, but no one my age. I'd like to think that my practice of mindfulness made me appreciate the time I did have with him, far more than I would have otherwise. If I lived the Stoic ideal, I would have told John how wonderful he was while he was still with us. I would have told him how he brightened my life each time I got to hang out with him. Instead, I'm saying it now.

    Our lives are short. Meditation is a way to appreciate every moment. We'll continue to lose our loved ones, our friends, so contemplate losing them each day, to appreciate them more while they're still here. Exercise is work to live longer. Meditation is work to live better.

    Wolters Kluwer Health, Inc. All rights reserved.